The 2017 Guyana Adventure of Rev Jo’c

John has been involved with St. Joseph Mercy Hospital since 2002. He has volunteered primarily at the School of Nursing and some Teaching in the Psychiatry Residency. He does get "out and about" especially to St. Ann's Girls Home and a few Lutheran Churches. This blog is an annotated diary of his Guyana experiences and reflections.

Thursday, December 14, 2017

So far their solution tells you that you shouldn't have done it in the first place.]

My First and Last Thought - Gratitude

I guess "Gratitude" is a feeling more than a thought or even an attitude. I just know that is what I feel as I remember my Guyana time this year. I wish I had a more complicated or sophisticated remembrance... I really do have many others:Frustration - that I can never seem to accomplish as much as I want or thought that I could do in September;Amazement - with the energy, drive, persistence, creativity [including all their unique excuses] of "my" beginning nursing students;Double Admiration - for my colleagues on the nursing faculty. I get lots of thanks for coming so far... I do like the recognition... AND I am humbled in the presence of my "teammates" who are really in the starting lineup everyday - Elsie, Candy, Roberta, Tracy and Yolanda. [There are part-timers whom I admire and would name if I thought I could name them all.]Pride - At first, I was congratulating myself for being "Mercy's Executive Volunteer" now for over 16 years... And then the truth hit me! By myself, I'd never have lasted. I have never gone alone though I have stayed there alone.

My wife, Anne, has traveled with me ever time - though she has mostly found ways to avoid the mosquitos, the heat and the humidity. Her traveling is done on another continent by enduring my neurotic needs for adventure and meaning and an almost total denial of my aging, when it would be her choice for me to be beside her. And she does it with love.

My larger family with our children and their children and well, not yet any children's children. They miss me when they aren't doing their own lives - that is how it should be. They do support my adventures, especially distracting Anne with their activities and achievements. And they do it with love.

My friends and supporters, who offer me encouragement with their words and donations [of course]. It is not the cash... it is what it means and I see that meaning every day I am in Guyana. I see:

tiled floors in the classrooms

classrooms that were raised a foot to stop the flooding rains from stopping classes,

movable desks and chairs for both classrooms to accommodate small learning groups, not mentioning more comfortable on their butts.

retracting, solid room divider to have a partition between the classes,

and every student with a tablet to do their homework, research and yes, social media.

These and many others sights are the meaning of your support. As well, there is so much unseen. Some of you give me money directly. I call it my "beer fund". However, there are so many more pressing needs - helping to pay someone's rent, transportation, meals, debts - I don't even have enough left over for good night's drinking. And they do it with love.

My fellow North American volunteers, those who have come down to work with me on PBL, I have undying admiration. I started adding an interesting comment to every name; however, I realized that they are still alive! So: Tony Carr, Dennis LeBlanc, Sylvia Wilvert, Emily Flynn, Charlie Malcolmson and Cathery Lee, Andrew Alan, Beverly Clark, Marysia Donnelly and like the blanket statement in confession, "for these and all my other sins volunteers I have forgotten... And they do it with love.

My Guyanese volunteers like, Derry Harry, Sandra LaRose, Ricky Chan who were faithful small group tutors. This year we had more need for volunteers and some old students, now professional RN's signed up, and came in on their days off, for facilitating small groups all term - Vikram Suklal, Ginelle Williams, Tiffany Scott, Jon Daly, Mowava Rodwell, Lovey Lamont and even Ariel Williams. There were others for previous years who we conscripted... who know who you are better than this old man's memory. And they do it with love.

My Guyanese friends who support me in so many ways and are more like family. My brother of a different mother, Bhiro Harry, who from the time he picked me up at the airport to the time he left me off there... he offers me physical - well, he likes beer , emotional and spiritual kindnesses. My son-like friend, Taju Olaleye and his family Allison, Tommy and Althea - now a nursing student. He is my importer - tablets, books, printers... all arrive quickly and safe. He was also the Maitre'd for many of my visitors and friends at The Princess. And then there is my personal banker, Michael Ram. I can give him a cheque, and instead of waiting for the 30-60 day wait to clear a foreign check,
it is in my ATM account right away. This is an enormous gift as anyone who knows my financial skills will attest. As well, he lets me borrow an Lutheran Church in Guyana cell phone. And they do it with love.

[Wow, this is getting longer than my planned introduction.]
My 2017 class of nursing students. They are the reason that I come down every year. I love to see how they struggle with new ideas and learn what they mean for their living. They are certainly not saints, yet they are inspiring for me and I want to offer them my best because they are truly "grateful" for what I do, even if I am a little sarcastic or their exam marks are less than they expected... And they do it with love.

Finally, I am thankful to Everyone! Yes, a little over the top and still true. Almost all the staff at Mercy go out of their way to answer all my requests; this especially includes Maintenance, Dietary, Laundry, Information Technology and Administration, especially Debbie Ramsey and Helen Browman. My "old" students greet me warmly coming and going to work, in the hallways, on the street... I do feel that I belong there by each kindness. And they do it with love.
Basta! Enough! I have left out great and important stuff, especially in the area of Psychiatry and mental health. Okay so I lied again. I want to write about my involvement with psychiatry there with Tony Carr, Peter Kuhnert and Shrenik Parekh. I guess if I write it in January 20128, then this post will be my last for 2017!

Grateful?

Before I left, I asked several overlooked departments if they could tell me one thing that I could give to them that would improve their working lives at Mercy. Of course, I was hoping that your would assist me in doing this. So if you can, consider providing these and you can share my feeling of gratitude.

Housekeeping - They needed a big fan for their office in order to keep their new computer from overheating. To show that I try and walk the talk... Anne and I brought them the fan.

Laundry - Must be the year of the fan as Laundry wanted a fan too, but more powerful. Believe me it is the hottest place in the whole hospital. I know that the fan costs @ $100. Cdn

Dietary - They must be the most Guyanese as I am still waiting for their request.

Maintenance - "Keith, I said one!" He must think you are really going to be grateful. He wrote, "Please see list below of tools needed for the Maintenance
Department."

1.Power analyzer ( Department would
able to do our own power analysis in house )

Sunday, October 29, 2017

FYI: John has given over his blog to a colleague... If you can only read his words they are in the next post below....

Day 1:
Out of the plane into the early morning sun and blinding heat - forgot
how hot the nights are here. Nice
man holding sign "Tony Carr" - ME!! - dodge the clamouring
taxi-drivers and let him drive through the crazy traffic, windows open to
enjoy the gestalt. And it all comes back
to me! The roads, the stores, this is
where we explored, this is where the special parts store is, this village is
where ..... Wonderful coming-home feeling.

Where to, sir? Oh dear, decisions. Well, I need cool trousers (shorts are
ridiculed here), and money, and milk.
But I need to see the accommodation to know what else. And I'd better find out about tomorrow's work
schedule? Dwayne kindly decides, drives
me to buy trousers ($6,000) and milk, and takes me to the Public Hospital.

Bhiro (the chief, indeed
the only permanentpsychiatrist in Georgetown) arrives, fixes
everything, Dwayne drives me to "Project Dawn" ... and now everything
changes. I walk through guarded locked
gates into a different world. Neat,
painted and tiled corridors, beautiful hardwood floor in HUGE living-room,
electronic keys, all clean and shiny and functioning. Can this be Guyana?

L. (my star pupil from Skype sessions)
drives me reluctantly to Taju's ("a very dangerous area, Dr. Carr, please
be careful"). Ecstatic welcome from
the Nigerian prince, then another from Rev John. Sit in pitch dark on roadside patio, with a
patron's car blasting unbelievably hi-fi reggae from the open doors, eat,
relax, laugh - like I've never been away.

Taju, Tony and "Free Ice Cream" Nathoya

Day 2:
Lizzie's at the gate. She lives
locally, so drives me all along the busy coast road to the city centre twice a
day. Traffic is terrifying - like those
pictures of Hong Kong ... plus occasional cows.

The hospital. Young guy shackled to his bed,
semi-conscious, b.i.b. police last night crazy on crack and pot. Stares when roused, but mute. L. shrugs - order more Haldol, move on. Taller older guy, off meds and crazy, talks to us - first
guy laughs to hear his story. Try to
bargain a bit with him.

A woman, 6' tall model, straight out of
magazine, spotless hair/face/clothes/figure, lying casually on stomach looking
resentfully at us ... shackled to the bed!
Replies sulkily to questions.
What? B.i.b. police from
juvenile jail? She's a young teen
who had a tantrum. Maybe this is
normal? At least we took the shackle
off.

A middle-aged aunt frantic cos the teenage
nephew won't take his meds and then has psychotic outbursts: she brings him every few months, we stuff him
full of injection, and they go home happily until it gets bad again. Agitated mother brings young man who abuses
crack, goes crazy, gets sick, stops crack, gets better, over and over again. What can we do?

A young man with his family. He flies out in the work-crew on a Monday to
the "interior" (jungle) for a couple of months (gold mining), chats
to his girl daily by phone, returns for a week back home. But last week he suddenly went very
strange, ran amok, and was put on the next plane home. Rational at interview but very odd,
disinhibited, no memory of the crisis. Sounds
acutely medical. Explain to family this may be serious, bring him back if
he gets any sicker.

The boss appears and buys us lunch! Have worked up good appetite for beef curry
and rice. Then off to the gynae ward
across the road. Nice warm breeze
blowing through the glassless windows, along with very loud street noises. Very pleasant old lady who had a tumour
removed 2 days ago - dementia/confusion - we discuss the need for another SW
home visit, because husband is 80, no kids nearby, what might be in her fridge?

Home at 4pm. Peep onto sunny patio but young woman
glares back at me, so hide in my room. Hey
- Shanti (my previous piano pupil) has invited me to her daughter's birthday
party - tonight! Hastily buy
store gift token as present, arrive just in time for huge family-and-church
birthday feast. Meet all the old friends
from church 6 years ago, warmly welcomed.
Good food and endless pop. Then a
ride home from Tabitha (worship-leader), because my digs are right close to the
church - aren't I blessed?

The gate-man here was a
bodyguard for the first Prime Minister, after independence in 1966 - went to
Russia with him. (That was the genius who
tore up the railroad to sell the iron to China.) And my boss was the 2nd PM's
bodyguard. Security is tough here.

Went to Mercy Hospital to
lecture, and got WARM welcome from an unexpected familiar face. She was one of our students years ago -- now
she's running the nursing school! Did
first talk, then used a glamorous student as model for the CNS, but the
students were a bit quiet.

I've borrowed Taju's
bike! I keep it in Rev John's apartment
- he carries it down the stairs for puny me - AND I located Winton, nice man in
Maintenance from years back, and oiled it - even adjusted the saddle (what a
relief.) Borrowed shorts from John (one can't
teach in shorts here) and pedalled down the sea-wall and around the park. Huge jets of milk-chocolate seawater
splashing up from the waves, great fun.

Working with the psych
residents continues to be amazing.
Yesterday we saw a mass-hysteria girl -- an outbreak of "seeing
spirits" at a girl's boarding-school.
And a tiny 12-year-old boy functioning exactly like a 6-year-old,
mentally and physically. And a schoolboy
who was suicidal because the family are plotting to kill him. And a mother so desperate about her immature,
angry, druggie, now-pregnant teenage daughter that she got the local police to
BRING her to the clinic.

Now a hectic day. Got ride with Lizz to Mercy, got the bike
from John, pedalled to the Public Hospital in rush-hour traffic! (I walked all the dangerous bits!) Locked the bike to the fence, saw patients
with Lizz, quick lunch (popcorn and Pepsi again), leapt on bike back to Mercy,
taught nursing students, got another Pepsi from canteen, biked back to Public,
saw patient, taught the residents, biked back to Mercy, out to nosh with John,
taxi home AND got him to stop so I could buy Crisp Rice, home by 8pm! I'm getting good value out of my time here.

I played truant today to keep Rev John
company. Walked across town in blinding
sunshine to Mercy ... er ... is that drops of rain!?? Almost my first ever in Guyana, I thought
happily, crossing the road carefully - and suddenly it's Hollywood rain,
catastrophic. I'm in shirtsleeves and
sandals. So I shelter in a doorway,
eventually get through to John, and kind nurse comes to rescue soggy me in her
car. Phew.

Bus driver is Rodney, drives steadily for 3
hours. Beautiful scenery along the coast
road, south almost to Suriname, lush green forest with LOTS of little villages
with curious names - "La Raisonnable", "Quaker Hall",
"Die Kinderer", "Just in Time", etc. - every few
kilometres. John explains these were
originally sugar-cane plantations worked by slaves, and whimsically named by
the owners.

The bin ("Guyana National Psychiatric Hospital")
looks like a Canadian pioneer village replica.Started in 1850, and almost unchanged.A smallish scrubby field with a dozen ancient buildings scattered
around, some derelict, and a few peasants ambling oddly about.Relaxed, quiet, dirty, hot.The original hospital building is still
there, huge, white-painted, wooden.

Have to badger John's students to talk to
the patients. (Come on! How old is she? Where from?
How long here? Wants to go
home? Gets any visitors?) Some get into the swing. The rest show an interesting cultural
divide: the Indian students go mute,
staring motionless in small groups. The
black students chat and giggle endlessly, ignoring the patients.

Some of the patients recognize John from
previous visits.Turns out many patients
have been here for around a decade - one or two recognized me.Another was adamant she was going home
"this week - Nurse promised me - I hope she doesn't change her mind
again!"All patients are
discharged home if humanly possible.The
ones left here are "unstable", or the family refuses to have them
back.So it's mainly an
old-people's-home.

On the way back we stop to show the girls
the "Jumbie Tree". Plantations
liked to import a huge cottonwood tree for good luck. (They live for 200 years or so.) Legend has it that one of the slaves who dug
the hole for this tree was buried with it as fertilizer (alive or dead, the
story varies), and that if you feel the tree's enormous roots you can still
feel his pulse. It is known as "the
jumbie tree" (i.e. zombie). When
the big coast road ("the Public Road", the main artery) was paved,
the workers refused to cut down this tree!
So the road divides around it, traffic hurtling past. Even now half our students refuse to go near
it - in 2017.

Sunday in my quiet digs. Tabitha calls re church: she has no car, so I
will need a taxi. Then calls back - the
church is sending a bus to the Native Hostel up my road, she asked if the bus
could collect me as well - and the bus driver is Rodney! "I know Dr. Carr, of course I'll pick
him up". Church shows video of the
founder's widow in India, a good message.
Get invited to lunch with Shanti, who plonks me into the senior Sunday-School class and leaves! Managed
to keep them awake and talking for the half-hour.

After lunch on her patio in a nice breeze
(very tasty grey rice goo) she asks if I like playing games, and proceeds to
beat me in 5 consecutive games of checkers ("draughts")! Then I tell Shanti my favourite game is
bridge - and she proceeds to learn it, fast!
Get a ride home with another church-member - they wouldn't let me walk
the last 200m in a nice sunset - too dangerous!

On
way to work see old man on bicycle carrying FOUR car tires, holding the top one
down with his chin. Do teaching session
with residents, walk back to Mercy, John's not there, but his flat is full of
nursing students studying with computers and discussing! Take another bike ride along the sea wall,
nice breeze to cool me. Home. Shanti
calls, sends taxi, feeds me, piano lesson for daughter, taxi back -- a fun life!

Go
out one day for supper with John and the eccentric chemistry Prof. Nibble hot fried cassava wedges - yummm. Almost get run over, my first time ever,
outside the sports bar: I will never
again cross the road with two people
(they suddenly ran opposite ways).

Clinic (every morning) is always fun. Man comes home
to visit mother from long spell abroad, with a LOT of money. Man becomes
catatonic within days, and money disappears. Father flies in to rescue him,
brings him to us, unable to speak, moves very slowly. Mother says oh, a cousin
put cocaine in his porridge. Medicine
Dept won't come, has no time for nutters. Neurologist is "away". A visiting psychiatrist comes up with a trick
- Ativan abreaction - bingo, he talks! ..... and is psychotic, reason unknown.)

Marvel at the names here - they gave up "Christian" names before we did. John's student nurses are (in order) Alica, Aqueeia, Asante, Ashana, Ayala, ... do you really want the rest?

At the hospital a magnificent example of leadership
skill. The chief walks in with a crying
lady staggering along, literally supported by her husband. He interviews her very capably for 5 minutes
... then gets up, motions me to take his chair, says happily "All
yours!", and leaves. Now THAT'S delegation.

Down to the sports bar with John to see Chelsea play
Crystal Palace. Great game, won by the Crystal Palace goalie! We watched
accompanied by the best juke-box I've ever heard. Teeth-rattling bass, from a
stack of speakers the size of a big wardrobe, playing 60's rock. I could live
here.

A fun Sunday. Played hooky from church - Taju drove me
across the Demerara river (a mile wide) to see his "farm". He's
bought a 40' x 800' plot on a new road through a derelict sugar plantation (was
worked by slaves - you can still see the deep-trodden gangways they carried the
cane along). The land is crazy expensive. For him it's like having a cottage.

Perhaps the strangest patient. He needed money for crack, so went to
brother's house, but only the kids are at home. So he tries to take the
2-year-old's gold ear-rings off. She screams. So he throws her through the window, goes out, rips off
the ear-rings, leaves her face-down in a puddle, covers her with a board, and
goes home. That's a psychopath.

We arrange to take all 6 residents to
the Grand Coastal hotel for a farewell poolside supper. It caters to Americans, is very cautious about
Guyanese people, and I have to charm each level of management in succession -
yet they themselves are all local! Our
residents too are unexpectedly ambivalent - "you want us to swim?" Maybe we've got it wrong? But I think they enjoyed it. Guyana is truly an amazing experience!